Healthcare Inspection Review of Facility Capabilities Where Veterans Received Complex Surgical Care

OIG conducted a retrospective review to characterize where seven complex and intermediate surgical procedures were performed at VHA facilities and at non-VHA facilities through fee basis arrangements prior to VHA’s release of Directive 2010-018, Facility Infrastructure Requirements To Perform Standard, Intermediate, Or Complex Surgical Procedures, on May 6, 2010. We found that VHA facilities had appropriate infrastructure to support surgeries performed. Although some surgeries were performed at VHA facilities with designations of lower complexity than required by the Directive, these surgeries were performed prior to the publication of the Directive, and we identified no adverse patient outcomes clearly attributable to facility infrastructure. We also found that VHA referred complex surgeries to non-VHA facilities with sufficient capabilities to support the surgeries performed. OIG made no recommendations.